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Code set update leads to amnesty for physicians

Physician Practice Insider, January 24, 2017

Some eligible professionals (EP) and group practices will get a pass for failing to meet 2016 Physician Quality Reporting requirements (PQRS) due to incomplete updates to ICD-10 code sets, CMS announced January 11. Failure to meet 2016 PQRS requirements would otherwise translate to negative payment adjustments in 2017 and 2018.

The fiscal year 2017 code update, released October 2016, saw an unusually large number of codes added or removed from the ICD-10 code set. Physician practices worked hard to keep coders up to speed on the changes but CMS’ analysis revealed that the code updates will impact the agency’s ability to process data on quality measures reported for the fourth quarter of 2016. CMS decided not to apply negative payment adjustments to EPs and group practices that fell short of the PQRS only because of the fiscal year 2017 code update. EPs or group practices that failed to meet the PQRS for other reasons can except to see negative payment adjustments in 2017 and 2018.

EPs and group practices should refer to CMS’ FAQs on PQRS and ICD-10 for more information.

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